Molecular testing on endobronchial ultrasound (EBUS) fine needle aspirates (FNA): Impact of triage

Sung, Simon; Crapanzano, John P.; DiBardino, David M.; Swinarski, David; Bulman, William A.; Saqi, Anjali

doi:10.1002/dc.23861

Cited by 32 publications

(30 citation statements)

References 62 publications

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“…The adoption of targeted NGS panels into the molecular diagnostic routine in laboratories provides not only higher sensitivity but also a reduction in sample quantity . Finally, the ability of NGS platforms to identify multiple gene mutations may improve the molecular diagnosis of patients with lung cancer, offer new therapeutic options, and assist oncologists in finding appropriate clinical trials for patients harboring actionable alterations . In addition to being responsible for selecting specimens with adequate tumor cellularity and ordering proper molecular tests, cytopathologists also are involved in ensuring appropriate cytological sample collection and preservation for molecular testing by performing rapid on‐site evaluation (ROSE) of cytology material .…”

Section: Comparison Between the Original Cap/iaslc/amp 2013 Recommendmentioning

confidence: 99%

“…In addition to being responsible for selecting specimens with adequate tumor cellularity and ordering proper molecular tests, cytopathologists also are involved in ensuring appropriate cytological sample collection and preservation for molecular testing by performing rapid on‐site evaluation (ROSE) of cytology material . In this context, cytopathologists or cytotechnologists performing ROSE must be familiar with the potential subsequent tests required for different types of specimens to maximize the fine‐needle aspiration (FNA) procedure . Altogether, in the era of personalized medicine, the concept of an “adequate sample” not only renders collected cytology specimens that are microscopically evaluable for diagnosis, but that also are of high quality for molecular testing.…”

Section: Comparison Between the Original Cap/iaslc/amp 2013 Recommendmentioning

confidence: 99%

“…9 Finally, the ability of NGS platforms to identify multiple gene mutations may improve the molecular diagnosis of patients with lung cancer, offer new therapeutic options, and assist oncologists in finding appropriate clinical trials for patients harboring actionable alterations. 1,10 In addition to being responsible for selecting specimens with adequate tumor cellularity and ordering proper molecular tests, cytopathologists also are involved in ensuring appropriate cytological sample collection and preservation for molecular testing by performing rapid on-site evaluation (ROSE) of cytology material. 11 In this context, cytopathologists or cytotechnologists performing ROSE must be familiar with the potential subsequent tests required for different types of specimens to maximize the fine-needle aspiration (FNA) procedure.…”

Section: Edited By Gilda Da Cunha Santos MD Phd Fiac Frcpcmentioning

confidence: 99%

“…11 In this context, cytopathologists or cytotechnologists performing ROSE must be familiar with the potential subsequent tests required for different types of specimens to maximize the fine-needle aspiration (FNA) procedure. 10 Altogether, in the era of personalized medicine, the concept of an "adequate sample" not only renders collected cytology specimens that are microscopically evaluable for diagnosis, but that also are of high quality for molecular testing.…”

Section: Edited By Gilda Da Cunha Santos MD Phd Fiac Frcpcmentioning

confidence: 99%

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The cytopathologist's expanding role in the 2018 updated molecular testing guidelines for lung cancer

Bellevicine¹,

Troncone²

2018

Cancer Cytopathology

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Section: Comparison Between the Original Cap/iaslc/amp 2013 Recommendmentioning

confidence: 99%

Section: Comparison Between the Original Cap/iaslc/amp 2013 Recommendmentioning

confidence: 99%

Section: Edited By Gilda Da Cunha Santos MD Phd Fiac Frcpcmentioning

confidence: 99%

Section: Edited By Gilda Da Cunha Santos MD Phd Fiac Frcpcmentioning

confidence: 99%

See 2 more Smart Citations

The cytopathologist's expanding role in the 2018 updated molecular testing guidelines for lung cancer

Bellevicine¹,

Troncone²

2018

Cancer Cytopathology

View full text Add to dashboard Cite

show abstract

“…There has been much emphasis on rapid on-site evaluation (ROSE) of minimally invasive cytology and small biopsy specimens in order to maximise the ability to obtain sufficient diagnostic material and samples for supplemental molecular or other ancillary testing. [1][2][3] This has become a critical component of patient care, as maximising the amount of diagnostic tissue from these procedures can limit the need for repeat procedures and/or more invasive procedures, which in turn can decrease health care costs, minimise complications for patients, and expedite care as well as improve patient satisfaction. In order to provide a ROSE service, institutions at some point may need to perform a cost-benefit analysis by examining its available resources including staffing, in order to satisfy clinical needs.…”

Section: Introductionmentioning

confidence: 99%

Telecytology implementation: Deployment of telecytology for rapid on‐site evaluations at an Academic Medical Center

Monaco

Koah

Xing

et al. 2018

Diagnostic Cytopathology

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Introduction There are limited publications that address technical and practical informatics considerations when implementing telecytology for rapid on‐site evaluation (ROSE). Our aim was to share the experience of deploying telecytology for ROSE at our institution. Materials and methods Key informatics issues relevant to adopting telecytology for ROSE at our institution were appraised including workflow, information technology (IT), validation, training, and quality assurance (QA). Results A dynamic telemicroscopy solution was selected that required trained cytotechnologists to attend on‐site procedures for ROSE. For validation 60 cases were reviewed using the first camera at each facility, but only 20 cases to validate subsequent cameras. A concordance rate of >90% between ROSE interpretation performed digitally to original interpretations was required for clinical validation. After reviewing 440 cases from two comparable time periods before and after implementation, employing telecytology was shown to decrease cytopathologists’ work time per ROSE case from an average of 20.95 min per case to 2.91 min per case (86% time savings). The non‐diagnostic rate for traditional ROSE was 7.7% compared with 4.1% after the implementation of telecytology, and the deferral rate went from 43.6% for traditional ROSE to 44.1% with telecytology. Traditional ROSE diagnoses correlated with final diagnoses in 91.8% cases, compared to 95.5% with telecytology. Conclusions Challenges when implementing telecytology for ROSE included technical issues, workflow concerns, and incorporating trainees into daily practice. The end result of our implementation was the adoption of an innovative way to deliver a ROSE service that maximised efficiency for cytopathologists without compromising diagnostic performance.

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Translational research: Empowering the role of pathologists and cytopathologists

Khella

Yousef

2018

Cancer Cytopathology

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Research activity is in the core essence of pathology. Advancing our understanding of disease pathogenesis translates into better patient care. Because of their unique position, laboratorians are the best to accurately identify, annotate, and classify research specimens. They also are essential for the accurate interpretation of genomic testing. Currently, cytopathologists are moving to the center of patient care through active communication with clinicians and patients. There are certain research areas in which cytopathologists can be pioneers, such as image analysis, morphology research, and genotype-phenotype association studies integrating morphologic and molecular features. Health service utilization research is another domain in which cytopathologists can excel. Successful research is a journey that necessitates multiple steps. It also involves building expertise in how to overcome obstacles and handle challenges. Cancer Cytopathol 2018;126:831-838. Commentary 832 Cancer Cytopathology October 2018Although they hold out hope of a significantly improved patient outcome by individualizing a treatment plan based on tumor biology, these new concepts carry a great challenge to the standard-of-care paradigms 6-9 and represent dramatic, revolutionary changes in the role of the cytopathologist. Molecular tests done for patients with different types of diseases are performed in the laboratory. The indication, interpretation, and clinical significance of a molecular test usually require active communication between laboratory team, clinicians, and patients. Consequently, the role of the cytopathologist's role is moving toward the center of patients' circle of care and becoming an active participant in multidisciplinary management teams that include clinicians, biologists, and pathologists, with input from patients. 10 The exponential growth in companion testing with molecular diagnostics has elicited discussion about the need to develop an integrated morphomolecular pathology specialty in which pathologists are equipped with combined molecular and morphologic expertise, enabling them to address the challenge of genomic medicine. 11 RESEARCH IN PATHOLOGYAn important question is why pathologists should be involved in research. There are several factors that necessitate the involvement of pathologists in research, and the advantages of getting pathologists involved in research include the following:

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Molecular testing on endobronchial ultrasound (EBUS) fine needle aspirates (FNA): Impact of triage

Abstract: ROSE with appropriate triage, including performing a dedicated pass and proper slide preparation, improves MT, and this is enhanced by having >1 cytologist at the start of the procedure. In the era of personalized medicine, "adequate" should denote sufficient tissue for diagnosis and MT.

Cited by 32 publications

References 62 publications

The cytopathologist's expanding role in the 2018 updated molecular testing guidelines for lung cancer

The cytopathologist's expanding role in the 2018 updated molecular testing guidelines for lung cancer

Telecytology implementation: Deployment of telecytology for rapid on‐site evaluations at an Academic Medical Center

Translational research: Empowering the role of pathologists and cytopathologists

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